DRUG NAME MECHANISM OF INDICATION / ADVERSE EFFECT NURSING

ACTION CONTRAINDICATION RESPONSIBILITIES

GENERIC: Acetaminophen Though to produce analgesia INDICATIONS: CNS:  Consider reducing
by inhibiting prostaglandin  Mild pain or fever  Agitation (IV) total daily dose and
BRAND: Paracetamol and other substances that  Rectal  Anxiety increasing dosing
sensitize pain receptors. Drug  Mild to moderate  Fatigue intervals in patients
THERAPEUTIC CLASS: may relieve fever through pain; mild to  Headache with hepatic or renal
NSAIDs central action in the moderate pain with  Insomnia impairment.
hypothalamic heat-regulating adjunctive opioid  Pyrexia  Tell parents to
DOSAGE: center. analgesics; fever consult prescriber
CV:
 Caplets: 500mg before giving drug to
 HTN
 Capsules: 325mg, children younger than
 Hypotension
500mg age 2.
 Peripheral edema
 Oral solution: CONTRAINDICATIONS:  Advise parents that
80mg/mL;  Periorbital edema
 Contraindicated in drug is only for short-
160mg/5mL; patients  Tachycardia (IV)
term use; urge them
167mg/5mL hypersensitive to GI:
to consult prescriber
 Suppositories: 80mg, drug. IV form is  Nausea
if giving to infants
120mg, 160mg, contraindicated in  Vomiting for longer than 3
325mg, 650mg patients with severe  Abdominal pain days, children for
 Tablets: 325mg, active liver disease.  Diarrhea longer than 5 days, or
500mg, 650mg  Use cautiously in  Constipation (IV) adults for longer than
patients with any type GU: 10 days.
ROUTE: Oral of liver disease,  Oliguria (IV)  Tell patient to consult
G6PD deficiency, Hematologic: prescriber for fever
chronic malnutrition,  Hemolytic anemia lasting longer than 3
severe hypovolemia,  Leukopenia days or recurrent
or severe renal  Neutropenia fever.
impairment.  Pancytopenia  Caution patient to
 Use cautiously in  Anemia contact health care
patients with long- Hepatic: provider if signs and
term alcohol use  Jaundice symptoms of liver
because therapeutic Musculoskeletal: damage occur.
 doses cause  Muscle spasms
hepatotoxicity in  Extremity pain (IV)
these patients. Respiratory:
Chronic alcoholics  Abnormal breath
shouldn’t take more sounds
than 2g of  Dyspnea
acetaminophen every  Hypoxia
24 hours.  Atelectasis
 Pleural effusion
 Pulmonary edema
 Stridor
 Wheezing (IV)
Skin:
 Rash
 Urticaria
 Infusion site pain
(IV)
 Pruritus

DRUG NAME MECHANISM OF INDICATION / ADVERSE EFFECT NURSING

ACTION CONTRAINDICATION RESPONSIBILITIES
GENERIC: Central dopamine receptor INDICATION: CNS:  Report the beginning of
Metoclopramide antagonist with high  Metoclopramide is a  Mild sedation restlessness,
potency. Although medication used to treat  Fatigue involuntary
BRAND: Reglan and structurally like the symptoms of sluggish  Restlessness movements, facial
Metozolv ODT procainamide, it has stomach emptying  Agitation grimacing, stiffness, or
minimal antiarrhythmic or (gastroparesis) in diabetic  Headache tremors as soon as
THERAPEUTIC CLASS: anesthetic action. The patients. It acts by possible.
 Insomnia
Prokinetic Agents precise method of action is enhancing the Extrapyramidal
 Disorientation
unknown; however, it contractions or motions symptoms are
DOSAGE: 10-15 mg appears to sensitize GI of the stomach and  Extrapyramidal particularly common in
smooth muscle to the intestines. It alleviates symptoms (acute dystonic children, young adults,
ROUTE: Oral effects of acetylcholine by symptoms such as type) and the elderly, as well
direct action. nausea, vomiting,  Neurologic malignant as with high dose
heartburn, feeling full syndrome with injection. vomiting treatment
after meals, and loss of GI: related with cancer
appetite.  Nausea chemotherapy. It might
 Constipation take months for
CONTRAINDICATIONS:  Diarrhea symptoms to subside.
 Sensitivity or intolerance  Dry mouth  Be warned that serum
to metoclopramide; aldosterone may be
 Altered drug absorption
allergy to sulfiting agents; raised during the early
Skin:
history of seizure treatment phase;
 Urticarial or
disorders; concurrent use however, during
maculopapular rash.
of drugs that can cause lengthy administration
extrapyramidal periods, it returns to
Body as a Whole:
symptoms; pretreatment levels.
 Glossal or periorbital
pheochromocytoma;  Lab tests: Periodic
edema.
tactile GI obstruction or serum electrolyte.
perforation; ileus; history  Monitor for
Hematologic:
of breast cancer; hypernatremia and
 Methemoglobinemia.
pregnancy (category B), hypokalemia (see
lactation, children 6 years Appendix F),
CV:
and younger, infants, and particularly if the
 Galactorrhea
neonates. patient has CHF or
 Gynecomastia cirrhosis.
 Amenorrhea  Adverse responses
 Impotence related with elevated
blood prolactin
concentrations
(galactorrhea,
menstrual problems,
gynecomastia)
normally resolve after a
 few weeks or months
of discontinuing
medication therapy.
 Avoid driving and
other potentially
dangerous activities for
a few hours after taking
the medication.
 Avoid alcohol and
other CNS depressants.
 Report to S&S any
signs of acute dystonia,
such as shaky hands
and facial grimacing
(see Appendix F), as
soon as possible.
 Do not breastfeed if
you are on this
medication without
first seeing your
doctor.

DRUG NAME MECHANISM OF INDICATION / ADVERSE EFFECT NURSING

ACTION CONTRAINDICATION RESPONSIBILITIES
GENERIC: Folic acid Vitamin B complex is INDICATION: [Reportedly non-toxic.  Prior to beginning
required to produce  Folic acid is Following IV administration, therapy, obtain a
BRAND: Folvite nucleoproteins and the commonly used to there is some flushing and a thorough history of
maintenance of normal treat megaloblastic sense of warmth.] nutritional consumption
THERAPEUTIC CLASS: erythropoiesis. Acts against anemias in as well as drug and
Vitamins, Water-Soluble. folic acid deficiency, which pregnancy. During alcohol use. Oral
inhibits thymidylate synthesis pregnancy, folic acid contraceptives, alcohol,
DOSAGE: 5 mg and results in the generation needs skyrocket, and barbiturates,
 of faulty DNA, resulting in a lack will result in methotrexate, phenytoin,
ROUTE: Oral megaloblast development and fetal harm. primidone, and
bone marrow maturation trimethoprim have all
arrest. been linked to folate
CONTRAINDICATION: insufficiency. Folate
 Folic acid alone is deficiency can also occur
used to treat because of renal dialysis.
pernicious anemia or  Keep the doctor up to
other vitamin B12 date on the patient's
deficient diseases, as reaction to therapy.
well as normocytic,  Subtherapeutic plasma
refractory, aplastic, or levels in phenytoin
unexplained anemia. patients should be
monitored.
 Patient & Family
Education
 While on folic acid
treatment, keep a tight
eye on your doctor. If
there is a risk of relapse,
the maintenance dosage
should be adjusted.
 Do not breastfeed if you
are on this medication
without first seeing your
doctor.

DRUG NAME MECHANISM OF INDICATION / ADVERSE EFFECT NURSING

ACTION CONTRAINDICATION RESPONSIBILITIES
GENERIC:  Antacid that acts INDICATION: GI:  Take note of the number
Calcium quickly yet has a  Calcium carbonate is used to treat  Constipation or laxative and consistency of stools.
strong osteoporosis, osteomalacia, effect If constipation is a
BRAND: Tums neutralizing hypothyroidism,  Acid rebound concern, the doctor may
capacity and a hypoparathyroidism,  Nausea recommend alternate or
THERAPEUTIC reasonably pseudohypoparathyroidism,  Eructation combination therapy with
CLASS: Antacids lengthy duration DiGeorge syndrome, kidney  Flatulence a magnesium antacid, or
of action. dysfunction, pancreatitis,  Vomiting the patient may be
DOSAGE: Reduces stomach rheumatoid arthritis, Fanconi advised to take a laxative
 Fecal concretions
Calcium carbonate: acidity, syndrome, pregnancy, nursing or stool softener as
125 mg, 250 mg, decreasing mothers, and postmenopausal Metabolic: needed.
650 mg, 750 mg, pepsin's women who have low serum  In patients on long-term
 Hypercalcemia with
1.25 g, 1.5 g tablets. proteolytic calcium levels. treatment and those with
alkalosis
activity on renal impairment, serum
Calcium acetate:  Metastatic calcinosis
gastric mucosa. CONTRAINDICATION: and urine calcium levels
667 mg tablets.  Hypercalciuria
Increases the  Hypercalcemia and should be determined on
tone of the lower  Hypomagnesemia a weekly basis.
hypercalciuria (for example,
Calcium citrate: 950 esophageal hyperparathyroidism, vitamin D  Hypophosphatemia  Keep track of any
mg, 2376 mg sphincter as well. overdosage, decalcifying tumors, (when phosphate intake improvements in
tablets. Even though it is bone metastases), calcium loss is low). hypocalcemia symptoms.
categorized as a due to immobilization, severe  Observe for signs and
Calcium phosphate non-systemic renal disease, renal calculi, GI CNS: symptoms of
tribasic: 1565.2 mg antacid, a mild to hemorrhage or obstruction,  Mood and mental hypercalcemia in patients
tablets severe alkalosis dehydration, hypochloremic changes. who are taking frequent
frequently alkalosis, ventricular fibrillation, or large doses of
ROUTE: Oral develops with cardiac disease, pregnancy Urogenital: medication, or who have
extended use. (category C).  Polyuria decreased renal function.
Acid rebound, Renal calculi.  Do not use this drug for
which can occur more than 1–2 weeks
after even since it may produce acid
modest dosages, rebound, which usually
is mediated by happens after 1–2 weeks
gastrin release of recurrent usage and
driven by leads to chronic use.
calcium action in Self-medication has the
the small potential to be hazardous.
intestine. Without medical
 supervision, do not use
antacids for more than 2
weeks.
 Take calcium carbonate
with caution if you eat
cereals or other meals
high in oxalates.
Oxalates and calcium
carbonate mix to
generate insoluble,
nonabsorbable
molecules.
 Calcium carbonate
should not be combined
with foods high in
vitamin D (such as milk)
or sodium bicarbonate on
a regular basis because it
can cause milk-alkali
syndrome, which
includes hypercalcemia,
food aversion, headache,
confusion, nausea,
vomiting, abdominal
pain, metabolic alkalosis,
hypercalciuria, polyuria,
soft tissue calcification
(calcinosis),
hyperphosphatemia, and
renal insufficiency.
Renal failure,
dehydration, electrolyte
imbalance, and
hypertension are all risk
 factors.
 Do not breastfeed if you
are on this medication
without first seeing your
doctor.